抗菌药物治疗呼吸内科患者33例相关性腹泻的临床体会

Clinical experience of 33 patients associated diarrhea antimicrobial treatment in respiratory medicine

目的探讨呼吸内科抗菌药物相关性腹泻的发生原因、如何预防、治疗方法及效果,并总结体会。方法选取本院呼吸内科2010年12月至2012年11月收治的抗菌药物引起的相关性腹泻患者33例,对所有患者立即停止引发相关性腹泻的抗菌药物的使用,给予患者补液、补钾、禁食等治疗,避免抑制肠蠕动药物的使用。结果 29例轻症患者的症状改善天数平均为(3.1±0.8)d,症状消失天数平均为(6.2±2.3)d,治愈率为100%;4例重症患者症状改善天数平均为(7.5±1.3)d,症状消失天数平均为(16.8±4.6)d,治愈率为75%;另外1例重症患者治疗无效后死亡。结论根据呼吸内科患者病情和个体差异选择用药,减少侵袭性治疗,同时给予早期进食和肠内营养,在给予患者抗生素治疗同时尽量补充足够的益生菌可使肠内菌群平衡,达到将抗菌药物相关性腹泻机率降到最低的目的 ,保证患者的生命安全。

Objective To investigate the causes, respiratory department of internal medicine antibiotic associated diarrhea prevention, treatment methods and effect, and summarize the experience.Methods 33 patients with diarrhea caused by antimicrobial drugs in our hospital in 2010 December to 2012 year in November the respiratory department of internal medicine treated cases, use of all patients to immediately stop the antibiotic associated diarrhea, patients were given rehydration, potassium, fasting treatment, avoid the use of inhibiting intestinal peristalsis.Results 29 cases of patients with mild symptoms improve the average number of days to（3.1±0.8） d, the symptoms disappeared days averaged（6.2±2.3） d, the cure rate was 100%; 4 cases of patients with severe symptoms improve the average number of days to（7.5±1.3） d, the symptoms disappeared days averaged（16.8±4.6） d, the cure rate was 75%; The other 1 cases in the treatment of the patients with after death.Conclusion The choice of drugs according to the condition of patients with respiratory department of internal medicine and individual difference, reducing invasive treatment, while giving the early feeding with enteral nutrition, the patients were given antibiotic therapy at the same time try to add enough probiotics can make intestinal flora balance, to achieve the antibiotic related diarrhea rate lowest objective, ensure the life of patients safety.